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  • 1.
    Björksved, Margitha
    et al.
    Department of Orthodontics, Public Dental Health Service, Eskilstuna, Sweden.
    Arnrup, Kristina
    Dental Research Department, Public Dental Service, Region Örebro County, Örebro, Sweden.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Magnusson, Anders
    Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Sundell, Anna Lena
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Gustafsson, Annika
    Department of Paediatric Dentistry, Postgraduate Dental Education Center, Örebro, Sweden.
    Bazargani, Farhan
    Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden.
    Closed vs open surgical exposure of palatally displaced canines: surgery time, postoperative complications, and patients' perceptions2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 40, no 6, p. 626-635Article in journal (Refereed)
    Abstract [en]

    Background: Closed and open surgical techniques are two different main approaches to surgical exposure of palatally displaced canines (PDCs). Because there is insufficient evidence to support one technique over the other, there is a need for randomized controlled trials.

    Objectives: To compare surgery time, complications and patients' perceptions between closed and open surgical techniques in PDCs.

    Trial design: The trial was a multicentre, randomized, controlled trial with two parallel groups randomly allocated in a 1:1 ratio.

    Material and methods: Study participants were 119 consecutive patients from 3 orthodontic centres, with PDCs planned for surgical exposure, randomly allocated according to a computer-generated randomization list, using concealed allocation. Full-thickness mucoperiosteal flap was raised, and bone covering the canine was removed in both interventions. In closed exposure, an attachment with a chain was bonded to the canine and the flap was sutured back with the chain penetrating the mucosa. In open exposure, a window of tissue around the tooth was removed and glass ionomer cement placed on the canine crown, to prevent gingival overgrowth during spontaneous eruption. Patient perceptions were assessed with two questionnaires, for the evening on the day of operation and 7 days post-surgery.

    Blinding: It was not possible to blind either patients or care providers to the interventions. The outcome assessors were blinded and were unaware of patients' intervention group.

    Results: Seventy-five girls and 44 boys, mean age 13.4 years (SD 1.46) participated in the study and got either of the interventions (closed exposure, n = 60; open exposure, n = 59). Surgery time did not differ significantly between the interventions. Complications though were more severe in bilateral cases and the patients experienced more pain and impairment in the open group.

    Conclusion: There were no statistically significant differences regarding surgery time between the groups. Postoperative complications were similar between the groups in unilateral PDCs, but more common in the open group in bilateral cases. More patients in the open group experienced pain and impairment compared to the closed group.

    Trial registration: Trial registration: ClinicalTrials.gov, ID: NCT02186548 and Researchweb.org, ID: 127201.

  • 2. Egermark-Eriksson, I
    et al.
    Carlsson, G E
    Magnusson, Tomas
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Thilander, B
    A longitudinal study on malocclusion in relation to signs and symptoms of cranio-mandibular disorders in children and adolescents.1990In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 12, no 4, p. 399-407Article in journal (Refereed)
  • 3.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Bjerklin, Krister
    Jönköping University, School of Health Science.
    Halling, A
    Self-perceived orthodontic treatment need and culturally related differences among adolescents in Sweden2005In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 27, no 2, p. 140-147Article in journal (Refereed)
  • 4.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Bjerklin, Krister
    Lindsten, Rune
    Factors determining perceived orthodontic treatment need in adolescents of Swedish and immigrant background2009In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 31, no 1, p. 95-102Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the association between self-perceived orthodontic treatment need and malocclusion in 12 to 13-year-old-adolescents of Swedish and immigrant background. The sample consisted of 379 students, stratified according to geographic background: both parents born in A/Sweden (n = 269), B/Eastern Europe (n = 56), and C/the Middle East (n = 54). Registrations were based on a questionnaire, a clinical examination, radiographs, and patient records. Treatment need was classified according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Logistic regression analysis was used for comparison of the results.

  • 5.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Bjerklin, Krister
    Lindsten, Rune
    Malocclusion frequency in Swedish and immigrant adolescents: influence of origin on orthodontic treatment need2007In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 29, no 1, p. 79-87Article in journal (Refereed)
    Abstract [en]

    Sweden has become increasingly multicultural, In the year 2000, almost 25 per cent of the child and adolescent population was of foreign origin. Such a major change in demographics may lead to altered orthodontic treatment need in the community, with implications for planning appropriate levels of orthodontic resources. The aim of this study was to compare the frequency of malocclusion and orthodontic treatment need in 12- and 13-year olds of Swedish and immigrant background. The subjects, n = 493, were stratified into four groups according to family origin: (A) subject and both parents born in Sweden, and subject or at least one parent born in (B) Eastern Europe, (C) Asia, or (D) other countries. Registrations were based on available radiographs, patient records, and a clinical examination. Normative treatment need was based on a number of variables. Treatment need was expressed according to the dental health component (DHC) and aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN).

    Group A exhibited the greatest space deficiencies and irregularities in the maxillary and mandibular anterior segments and also the greatest overjet. More primary molars had been extracted in groups B and C, with a positive correlation between early extraction of primary molars and retention of permanent successors. Self-assessed orthodontic treatment need, IOTN-AC, was highest in group A. For all four groups, the orthodontist's estimate of treatment need was significantly higher than the subjects' self-assessed need.

    This study confirms that, despite the change in demographics, variations in frequencies of malocclusion and treatment need among children of different cultural background are only minor and the overall orthodontic treatment need remains unchanged.

  • 6.
    Josefsson, Eva
    et al.
    Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Treatment of missing maxillary lateral incisors: a clinical and aesthetic evaluation2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 3, p. 273-278Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate whether implant therapy or orthodontic space closure was the best treatment option for patients with missing maxillary lateral incisors.

    Subjects and methods: The implant group (I group) consisted of 22 patients aged <26 years who had one or both maxillary lateral incisors substituted by a single implant-supported crown. The space-closure group (SC group) consisted of patients matched with I group patients based on diagnosis, gender, and number. Examinations were performed by one examiner and occurred at least 5 years after the prosthetic therapy or orthodontic treatment was finished. Clinical examination of the 44 patients involved assessing the aesthetics and gingival conditions of the implant-supported crown and the replacement canine, the occlusal morphology and the extraoral characteristics. Both the patient and examiner answered a question about their satisfaction with the aesthetic result.

    Results: Of the 12 variables analysed by the examiner, one variable was significantly improved in the I group and five variables were improved in the SC group. There were no significant differences between the treatment groups for the remaining six variables. Gingival colour and crown length were better in the SC group, and crown colour was better in the I group. There were no significant differences between the groups with regards to the patient's and examiner's overall aesthetic satisfaction of the maxillary anterior teeth or between the patient's and examiner's opinion.

    Conclusion: If both treatment alternatives are available, space closure is preferable.

  • 7.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Early orthodontic treatment and interceptive treatment strategies2013In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 35, no 2, p. 190-Article in journal (Refereed)
    Abstract [en]

    Orthodontics as health care is sometimes at odds with modern marketing with its strong focus on aesthetics. In this commentary, I highlight how important it is that research of orthodontic treatment as a value for the entire community is performed and published.

  • 8.
    Lindsten, Rune
    Jönköping University, School of Health Science, HHJ. Oral health.
    The effect of maceration on the dental arches and the transverse cranial dimensions: a study on the pig2002In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 24, no 6, p. 667-676Article in journal (Refereed)
    Abstract [en]

    The dimensional change of the dental arches and the transverse cranial dimensions were studied in the pig to gain information on cranial post mortem changes and thus improve the possibilities of comparison between modern and skeletal samples. Dental arch dimensions were registered in 17 pigs within 30 minutes after they had been killed. The following day, the skulls were registered on lateral and axial radiographs. The animals were prepared, and storage and preparation included freezing and treatment in hot water. The water temperature did not exceed 65 degrees C. After this process, the skulls were again registered on lateral and axial radiographs. The skulls were then allowed to dry for 2 weeks and the direct measurements were repeated. The dimensions showed shrinkage of between 0 and 3.3 per cent. The mandible showed a greater change transversally in the posterior region than the cranium, which may have been due to its shape. The more deviant values for dimensional change were probably due to technical errors and the shrinkage may be expected to vary from 0.3 to 1.7 per cent, with greater values occurring in the posterior transverse parts of the mandible. A differential shrinkage in the maxilla could not be excluded and the values varied between 0.3 and 1.9 per cent. The results indicate that the crania in skeletal samples can be expected to be 0.3-1.7 per cent smaller than in vivo.

  • 9. Lindsten, Rune
    et al.
    Larsson, Erik
    Øgaard, Bjørn
    Dummy-sucking behaviour in 3-year old Norwegian and Swedish children1996In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 18, no 2, p. 205-209Article in journal (Refereed)
    Abstract [en]

    Forty 3-year-old dummy-sucking children (22 Swedes and 18 Norwegians) together with one of their parents, were shown a specially prepared videotape for 15 minutes The child had free access to its dummy while watching the video. The dummy-sucking time and sucking reactions to the different film sequences were registered. The presence or absence of a posterior crossbite was recorded as well as the upper and lower intercanine arch widths. Dummy-suckers in these populations have earlier been reported to have different prevalences of posterior crossbite. The prevalence of posterior crossbite was especially high for Swedish girls. The results showed that Norwegian boys used their dummies significantly less, and the Swedish girls had significantly narrower upper dental arches than the other children. Dummy-sucking reactions to frightening, cheerful or boring parts of the video were not significantly different among the children. All the children showed compassion for the film characters, and all the children used the dummy when going to sleep. The study lends support to the hypothesis that dummy-sucking influences arch widths and increases the likelihood for development of a posterior crossbite.

  • 10. Lundgren, D
    et al.
    Kurol, J
    Thorstensson, B
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Periodontal conditions around tipped and upright molars in adults: An intra-individual retrospective study.1992In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 14, no 6, p. 449-455Article in journal (Refereed)
    Abstract [en]

    In 69 individuals from a randomized epidemiological material comprising 450 adults, an intra-individual comparison of the periodontal condition of 73 mesially tipped molars (30 degrees or more to a line perpendicular to the occlusal plane) and contralateral upright molars was made. The alveolar bone level mesially and distally of each tooth was registered in periapical radiographs. The occurrence of plaque, gingivitis and probeable pocket depths of 4 mm or more mesially and distally of each tooth was registered. No significant differences between tipped and upright molars could be found, regardless of the variable tested. The clinical implications of the findings are discussed from an orthodontic as well as a periodontal and prosthetic point of view.

  • 11.
    Schütz-Fransson, Ulrike
    et al.
    Orthodontic Clinic, Mölndal, Sweden.
    Bjerklin, Krister
    The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Lindsten, Rune
    Jönköping University, School of Health Science, HHJ. Oral health.
    Long-term follow-up of orthodontically treated deep bite patients2006In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 28, no 5, p. 503-512Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the long-term stability of corrected deep bite and mandibular anterior crowding in a sample of 62 subjects (30 patients and 32 controls). The patients began treatment at a mean age of 12.2 years (SD 1.56). The treatment consisted of non-extraction and fixed appliances in 23 subjects and functional appliances in seven. The treatment group was compared with the control group with normal molar occlusion, normal overjet and overbite, no crowding, and without an orthodontic treatment need. The registrations were made on four occasions: before treatment (T1), after treatment (T2), and at two long-term follow-ups (T3 and T4). Four registrations were also made in the control group. All measurements were undertaken on plaster models and lateral cephalograms. Treatment was found to have normalized the overbite and overjet and to have eliminated the space deficiency in the mandibular anterior region. At T4, there was a minor relapse in overbite in the treatment group (mean 0.8 mm). In the control group, the overbite underwent reverse development (bite opening by 0.7 mm) during the same period. The available mandibular incisor space, however, was -0.9 mm in the treatment group and -1.8 mm in the control group. The long-term stability of the treatment results was thus good.

  • 12.
    Stange, Karolina Mikkelä
    et al.
    Department of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden .
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden.
    Bjerklin, Krister
    Department of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden.
    Autotransplantation of premolars to the maxillary incisor region: A long-term follow-up of 12-22 years2016In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 38, no 5, p. 508-515Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the long-term outcome of treatment of missing maxillary incisor teeth by transplantation of premolars, with special reference to aesthetics and patient satisfaction.

    Subjects and Methods: Twenty subjects who had undergone transplantation of premolars to the maxillary incisor area were recalled for follow-up varying between 12 and 22 years post-surgery. Twelve subjects presented for examination, including radiography and three subjects participated only by answering questions. Three reference groups-general practitioners, orthodontists, and lay people-evaluated the aesthetic results from photographs. Patient satisfaction was evaluated by interviews and OHIP-14.

    Results: The mean age at transplantation was 12.3 years: 1 subject had been 20 years old and 11 were in the range of 9-14 years. Twelve to 22 years after autotransplantation, 5 subjects could not be reached: of the 15 who could be contacted, the survival rate was 15 out of 15. In the 12 subjects who presented for clinical examination, 11 out of the 12 transplants were assessed as successful. Nine transplants were restored with crowns and five had been recontoured with composite build-ups. In one patient, no restorative treatment had been undertaken. The subjects were satisfied with the aesthetic result.

    Conclusion: Autotransplantation of premolars is an appropriate method for treatment of missing maxillary anterior teeth. Subjects with a transplanted tooth to the maxillary anterior region perceive their oral health as good long term.

  • 13.
    Zasciurinskiene, Egle
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lund, H.
    Department of Oral and Maxillofacial Radiology, Sahlgrenska Academy, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Departments of Orthodontics, Institute for Postgraduate Dental Education, Sweden.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Periodontology, Institute for Postgraduate Dental Education, Sweden.
    Bjerklin, K.
    Departments of Orthodontics, Institute for Postgraduate Dental Education, Sweden.
    Outcome of orthodontic treatment in subjects with periodontal disease. Part III: a CBCT study of external apical root resorption2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 6, p. 575-582Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    No evidence is present on the risk for external apical root resorption (EARR) during orthodontic treatment (OT) of adult patients with periodontal disease.

    AIM:

    To examine EARR after OT in subjects with periodontal disease and to analyse how intrusion and change in inclination of the most proclined maxillary incisors influence EARR.

    METHODS:

    The study included 50 patients with periodontal disease. Sub-gingival debridement by ultrasonic instrumentation supplemented with hand instruments was performed by experienced dental hygienist after baseline examination for all patients. For the control group, final periodontal treatment (PT) was performed before orthodontic tooth movement. For the test group patients, final PT was performed after levelling and alignment phases were finished, before the active space closure with elastic chain and/or inter-arch elastic traction for sagittal correction was started. OT was performed with a straight-wire appliance. Micro-implants or implants were used for posterior anchorage. Cone beam computed tomography examinations were performed before and after OT. EARR of all single-rooted teeth were measured. EARR of the most proclined maxillary incisor was related to intrusion and change in inclination angle.

    RESULTS:

    EARR after OT was observed in median 80.7 per cent (interquartile range 22.02) of single-rooted teeth [mean 1.2 (standard deviation 0.44) mm]. In 82.3 per cent of teeth, EARR was 2 mm or less. Severe EARR was found in 8 per cent of patients and five maxillary incisors (less than 1 per cent of all teeth). The amount of intrusion and change in inclination angle of the most proclined maxillary central incisor influenced the extent of EARR. Mean EARR was significantly higher when OT lasted more than 18 months (P = 0.02).

    CONCLUSIONS:

    OT in conjunction with PT in periodontal patients resulted in EARR in 81 per cent of all single-rooted teeth. Intrusion and change in inclination angle of the most proclined maxillary central incisor influenced the extent of EARR, as did longer OT. 

  • 14.
    Zasciurinskiene, Egle
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lund, H.
    Department of Oral and Maxillofacial Radiology, Sahlgrenska Academy, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Departments of Orthodontics, Institute for Postgraduate Dental Education, Sweden.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Periodontology, Institute for Postgraduate Dental Education, Sweden.
    Bjerklin, K.
    Departments of Orthodontics, Institute for Postgraduate Dental Education, Sweden.
    Outcome of periodontal-orthodontic treatment in subjects with periodontal disease. Part II: a CBCT study of alveolar bone level changes2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 6, p. 565-574Article in journal (Refereed)
    Abstract [en]

    AIM:

    To examine alveolar bone level (ABL) changes before (T1) and after (T2) orthodontic treatment (OT) in subjects with periodontal disease.

    METHODS:

    The study included 50 subjects with periodontal disease. All patients received subgingival debridement following baseline examination. Control group patients received final periodontal treatment before the start of OT. For the test group patients final periodontal treatment was performed simultaneous to OT. OT was performed with a straight-wire appliance. Micro-implants or temporary crowns on implants were used for posterior anchorage when needed. ABL measurements of 3821 tooth surfaces were performed on cone beam computed tomography images.

    RESULTS:

    No difference was observed between mean ABL at T1 and T2. ABL remained unchanged on 69 per cent of surfaces. A mean of 15.6 (SD 7.4) per cent of surfaces experienced ABL gain, and a mean of 15.1 (SD 7.5) per cent was found with ABL loss. Small significant median ABL difference was observed on mesial and distal surfaces (P < 0.001). A significant difference was found between median ABL changes on mesial/distal in comparison to buccal/lingual surfaces (P < 0.01). Significantly more buccal (17.9 %) and lingual (18.5 %) surfaces experienced ABL loss when compared with mesial (11.3 %) and distal (12.0 %) surfaces (P < 0.001). Significant difference was found in the median ABL change of intruded (0.5 (IQR 0.94) mm) and non-intruded (-0.4 (IQR 1.07) mm) maxillary incisors (P = 0.04). Significant median ABL gain was found on the lingual surface of maxillary incisors, which were retroclined more than 8.6 degree and intruded more than 1.6 mm.

    CONCLUSIONS:

    ABL changes after periodontal-orthodontic treatment in patients with periodontal disease were small. ABL gain was more observed on mesial and distal surfaces and ABL loss on buccal and lingual surfaces. Larger orthodontic movements of maxillary incisors influenced ABL gain. 

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